Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, 's Gravendijkwal 230, 3015, Rotterdam, CE, The Netherlands.
Int J Cardiovasc Imaging. 2012 Aug;28(6):1307-14. doi: 10.1007/s10554-011-9981-4. Epub 2011 Nov 23.
Serial intravascular ultrasound virtual histology (IVUS-VH) after implantation of metallic stents has been unable to show any changes in the composition of the scaffolded plaque overtime. The everolimus-eluting ABSORB scaffold potentially allows for the formation of new fibrotic tissue on the scaffolded coronary plaque during bioresorption. We examined the 12 month IVUS-VH changes in composition of the plaque behind the struts (PBS) following the implantation of the ABSORB scaffold. Using IVUS-VH and dedicated software, the composition of the PBS was analyzed in all patients from the ABSORB Cohort B2 trial, who were imaged with a commercially available IVUS-VH console (s5i system, Volcano Corporation, Rancho Cordova, CA, USA), immediately post-ABSORB implantation and at 12 month follow-up. Paired IVUS-VH data, recorded with s5i system, were available in 17 patients (18 lesions). The analysis demonstrated an increase in mean PBS area (2.39 ± 1.85 mm(2) vs. 2.76 ± 1.79 mm(2), P = 0.078) and a reduction in the mean lumen area (6.37 ± 0.90 mm(2) vs. 5.98 ± 0.97 mm(2), P = 0.006). Conversely, a significant decrease of 16 and 30% in necrotic core (NC) and dense calcium (DC) content, respectively, were evident (median % NC from 43.24 to 36.06%, P = 0.016; median % DC from 20.28 to 11.36%, P = 0.002). Serial IVUS-VH analyses of plaque located behind the ABSORB struts at 12-month demonstrated an increase in plaque area with a decrease in its NC and DC content. Larger studies are required to investigate the clinical impact of these findings.
在金属支架植入后，连续的血管内超声虚拟组织学（IVUS-VH）未能显示支架斑块的组成随时间的任何变化。依维莫司洗脱 ABSORB 支架在生物吸收过程中可能会在支架冠状动脉斑块上形成新的纤维组织。我们检查了 ABSORB 支架植入后支架小梁后（PBS）斑块的 12 个月 IVUS-VH 成分变化。使用 IVUS-VH 和专用软件，对 ABSORB Cohort B2 试验中所有患者的 PBS 成分进行了分析，这些患者使用商业 IVUS-VH 控制台（s5i 系统，Volcano Corporation，Rancho Cordova，CA，USA）进行成像，即刻在 ABSORB 植入后和 12 个月随访时。记录在 s5i 系统上的配对 IVUS-VH 数据可用于 17 名患者（18 个病变）。分析显示 PBS 面积的均值增加（2.39 ± 1.85 mm2 比 2.76 ± 1.79 mm2，P = 0.078），管腔面积的均值减少（6.37 ± 0.90 mm2 比 5.98 ± 0.97 mm2，P = 0.006）。相反，坏死核心（NC）和致密钙（DC）含量分别明显减少 16%和 30%（NC 中位数从 43.24%降至 36.06%，P = 0.016；DC 中位数从 20.28%降至 11.36%，P = 0.002）。12 个月时 ABSORB 支架小梁后斑块的连续 IVUS-VH 分析显示，斑块面积增加，NC 和 DC 含量减少。需要更大的研究来探讨这些发现的临床影响。
